Approximately one out of three adults has high blood pressure, which, if untreated, puts them at increased risk of dying young from heart disease, stroke, or kidney disease. These risks are all reduced when a hypertensive person is treated, but the question for medical experts has always been: how low should blood pressure go to maximize good health?
A study called SPRINT was begun by the National Institutes of Health (NIH) in 2009 to settle this question. The study was planned to continue until 2017, but the NIH last week took the very unusual step to stop the study early, because the results were so clear: that using 120 mmHg as a systolic blood pressure goal for hypertensives was superior, and would save many lives.
Until this report, the standard practice in the medical community was to try to lower the systolic pressure (the higher of the two blood pressure numbers) to 140, and for those over 60, to 150. Many doctors were wary of lowering the blood pressure lower than this since they worried that the side effects of aggressive blood pressure lowering would actually harm people. The fear was that the medication side effects would be harmful, or that people with blood pressure lowered to 120 would cause some people to faint, and injure themselves by falling.
But the results of the study were clear: if possible, people with hypertension should have 120 as their target blood pressure. The NIH study was rather simple. The researchers took 9300 men and women over the age of 50 and divided these people into two groups. One group was treated more aggressively, so that their systolic blood pressure would be no more than 120, while the other group was treated so that their blood pressure would follow the older guidelines of 140 as a target.
The results showed that those who were treated to a target blood pressure of 120 mmHG had a 30% lower risk of heart attack, stroke, and heart failure than the people with the higher target blood pressure. And the risk of dying during the study period was 23% lower for the group treated to the lower blood pressure target.
Some people with high blood pressure can be successfully treated with weight loss, exercise, or lowering salt intake, but most people with this problem will eventually require medication to bring their blood pressure under control. Doctors in the SPRINT study found that most patients required a combination of two different medications to achieve the blood pressure target of 140, and a combination of three drugs to achieve the new recommended target of 120.
If you have high blood pressure, talk to your doctor about this study and see if you should consider a change in your treatment. Every case is different, and these medications all have potential side effects, so it is not something you want to try by yourself.
Finally, if you are one of the many people who may have high blood pressure and have not yet been treated, this study is a good reminder about how you can reduce your risk of stroke and other problems by starting treatment.
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